1
|
M S, Sunil BN, R V. Prevalence of Non-communicable Disease Risk Factors Among Adults in a Rural Field Practice Area of a Tertiary Care Medical Center in Karnataka. Cureus 2024; 16:e67474. [PMID: 39310555 PMCID: PMC11415934 DOI: 10.7759/cureus.67474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2024] [Indexed: 09/25/2024] Open
Abstract
Background Non-communicable diseases (NCDs), also referred to as chronic diseases, typically have a long duration and arise from a combination of genetic, physiological, environmental, and behavioral factors. Each year, 17 million people under the age of 70 die from non-communicable diseases (NCDs), with 86% of these premature deaths occurring in low- and middle-income countries. Objectives To estimate the prevalence of NCD risk factors among adults (18-65 years) in a rural population. Methods A cross-sectional study was conducted by selecting 200 participants from 200 households using convenience sampling. Participants aged 18-65 years were included, and locked households were excluded. Sociodemographic profiles were assessed using semi-structured questionnaires, and NCD risk factors were assessed using a Community-Based Assessment Checklist (CBAC). Descriptive statistics and associations were analyzed. Results The majority of participants were men (53.5%), married (89.5%), and belonged to the class 2 socioeconomic classification. The prevalence of NCD risk factors was 17%, with smoking (12.5%), alcohol consumption (6%), and waist circumference (1.8% for men and 27.9% for women) being the most common risk factors. Older age, lower educational attainment, unemployment, and lower-income classes were associated with a higher risk of NCDs. Conclusion The study identifies key risk factors for non-communicable diseases (NCDs) as family history, waist circumference over 90 cm, daily alcohol consumption, and tobacco use, all significantly increasing the risk. Physical activity under 150 minutes per week and occupational exposure to crop residue showed no significant effect.
Collapse
Affiliation(s)
- Sankiya M
- Community Medicine, Sri Devaraj Urs Medical College (SDUMC) Sri Devaraj Urs Academy of Higher Education and Research (SDUAHER), Kolar, IND
| | - B N Sunil
- Community Medicine, Sri Devaraj Urs Medical College (SDUMC) Sri Devaraj Urs Academy of Higher Education and Research (SDUAHER), Kolar, IND
| | - Varun R
- Community Medicine, Sri Devaraj Urs Medical College (SDUMC) Sri Devaraj Urs Academy of Higher Education and Research (SDUAHER), Kolar, IND
| |
Collapse
|
2
|
Boakye H, Atabila A, Hinneh T, Ackah M, Ojo-Benys F, Bello AI. The prevalence and determinants of non-communicable diseases among Ghanaian adults: A survey at a secondary healthcare level. PLoS One 2023; 18:e0281310. [PMID: 36753484 PMCID: PMC9907821 DOI: 10.1371/journal.pone.0281310] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 01/20/2023] [Indexed: 02/09/2023] Open
Abstract
The current epidemiological transition of diseases in Ghana necessitates understanding their burden and the associated context-specific risk factors to inform disease prevention strategies. To determine the prevalence and determinants of selected Non-Communicable Diseases (NCDs) among patients seeking healthcare services in a secondary health facility in Ghana. A facility-based survey was conducted among adult patients 18 years and above between May and July 2021, using a multi-stage sampling approach. Data regarding the prevalence of NCDs, participants' socio-demographics and lifestyle factors of NCDs were obtained using Modified STEPwise Approach to NCD Risk Factor Surveillance (STEPS). The Chi-square test and regression analysis were performed to identify the risk factors of NCDs at P < 0.05. The participants comprised 480 patients with a mean age of 37.7±16.5 years, and 57.7% (277/480) of them were females. The overall prevalence of the selected NCDs was 26.7% (CI = 0.23-0.31), of which hypertension (22.7%) was the most prevalent. More than half (54.2%) of the participants engaged in alcohol consumption and 54% were physically inactive. The odds of developing NCDs were higher in females (CI = 1.32-4.10, P = 0.004), older adults (CI = 4.11-20.68, P <0.001), overweight/obese adults (CI = 1.65-4.70, P < 0.001), family history (CI = 0.15-0.46, P<0.001), and alcohol consumption (CI = 0.12-0.40, P < 0.001). There was an overall high prevalence of NCDs, strongly influenced by the participants' age, sex, BMI, alcohol consumption, and family history. These determinants should be highlighted as part of the campaign for preventive action plans.
Collapse
Affiliation(s)
- Hosea Boakye
- Physiotherapy Department, LEKMA Hospital, Accra, Ghana
- Department of Biological, Environmental and Occupational Health, School of Public Health University of Ghana, Accra, Ghana
- * E-mail:
| | - Albert Atabila
- Department of Biological, Environmental and Occupational Health, School of Public Health University of Ghana, Accra, Ghana
| | - Thomas Hinneh
- School of Health Sciences, University of Dundee, Dundee, Scotland, United Kingdom
- Tain District Hospital, Ghana Health Service, Nsawkaw, Ghana
| | - Martin Ackah
- Physiotherapy Department, Korle-Bu Teaching Hospital, Accra, Ghana
| | | | - Ajediran I. Bello
- Department of Physiotherapy, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Accra, Ghana
| |
Collapse
|
3
|
Pengpid S, Peltzer K. Prevalence and associated factors of physical inactivity among middle-aged and older adults in India: results of a national cross-sectional community survey. BMJ Open 2022; 12:e058156. [PMID: 36028277 PMCID: PMC9422873 DOI: 10.1136/bmjopen-2021-058156] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE This study aimed to determine the prevalence and associated factors of physical inactivity in middle-aged and older adults in India. DESIGN Population-based cross-sectional study. SETTING Nationally representative sample of general community-dwelling middle-aged and older adult population in India. PARTICIPANTS The sample included 72 262 adults (45 years and older, mean age 58.8 years, SD=11.8), from the longitudinal ageing study in India wave 1 in 2017-2018. PRIMARY AND SECONDARY OUTCOME MEASURES Self-reported physical activity, along with physical measurements, health status and health behaviour, and sociodemographic covariates. Multivariable logistic regression calculated OR with 95% CI for physical inactivity. RESULTS Overall, 36.7% were physically inactive, 42.6% among men, and 32.4% among women (p<0.001). In the adjusted logistic regression analysis, among both men and women, older age (70 years and older), being Sikh, impaired vision and depressive symptoms were positively and cognitive functioning, current tobacco use and social participation were negatively associated with physical inactivity. In addition, among men, higher socioeconomic status, urban residence, functional disability and heart disease or stroke were positively associated with physical inactivity, and among women being married and higher education were negatively, and insomnia symptoms and poor or fair self-rated health status were positively associated with physical inactivity. CONCLUSIONS Almost 4 in 10 middle-aged and older adults in India had inadequate physical activity. Overall and gender specific risk factors for physical inactivity were identified. Interventions may operate at multiple levels and consider gender-related physical inactivity patterns.
Collapse
Affiliation(s)
- Supa Pengpid
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand
- Department of Public Health, Sefako Makgatho Health Sciences University, Pretoria, Gauteng, South Africa
| | - Karl Peltzer
- Department of Psychology, University of the Free State, Bloemfontein, Free State, South Africa
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
| |
Collapse
|
4
|
Guo WL, Cao YJ, You SZ, Wu Q, Zhang F, Han JZ, Lv XC, Rao PF, Ai LZ, Ni L. Ganoderic acids-rich ethanol extract from Ganoderma lucidum protects against alcoholic liver injury and modulates intestinal microbiota in mice with excessive alcohol intake. Curr Res Food Sci 2022; 5:515-530. [PMID: 35281335 PMCID: PMC8913248 DOI: 10.1016/j.crfs.2022.02.013] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 02/12/2022] [Accepted: 02/20/2022] [Indexed: 12/13/2022] Open
Abstract
Alcoholic liver injury is mainly caused by excessive alcohol consumption and has become a global public health problem threatening human health. It is well known that Ganoderma lucidum possesses various excellent beneficial effects on liver function and lipid metabolism. The purpose of this study was to evaluate the underlying protective effect and action mechanism of ganoderic acids-rich G. lucidum ethanol extract (GLE) on alcohol-induced liver injury in mice with excessive alcohol intake. Results showed that oral administration of GLE could obviously inhibit the abnormal increases of serum triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), aspartate aminotransferase (AST) and alanine aminotransferase (ALT), and also significantly protect the liver against alcohol-induced excessive hepatic lipid accumulation and pathological changes. In addition, alcohol-induced oxidative stress in liver was significantly ameliorated by the dietary intervention of GLE through reducing the hepatic levels of maleic dialdehyde (MDA) and lactate dehydrogenase (LDH), and increasing the hepatic levels of glutathione (GSH), catalase (CAT), superoxide dismutase (SOD) and alcohol dehydrogenase (ADH). Compared with the model group, GLE intervention significantly ameliorated the intestinal microbial disorder by elevating the relative abundance of Ruminiclostridium_9, Prevotellaceae_UCG-001, Oscillibacter, [Eubacterium]_xylanophilum_group, norank_f_Clostridiates_vadinBB60_group, GCA-900066225, Bilophila, Ruminococcaceae_UCG-009, norank_f_Desulfovibrionaceae and Hydrogenoanaerobacterium, but decreasing the proportion of Clostridium_sensu_stricto_1. Furthermore, liver metabolomic profiling suggested that GLE intervention had a significant regulatory effect on the composition of liver metabolites in mice with excessive alcohol intake, especially the levels of some biomarkers involved in primary bile acid biosynthesis, riboflavin metabolism, tryptophan metabolism, biosynthesis of unsaturated fatty acids, fructose and mannose metabolism, glycolysis/gluconeogenesis. Additionally, dietary supplementation with GLE significantly regulated the mRNA levels of key genes related to fatty acids metabolism, ethanol catabolism and inflammatory response in liver. Conclusively, these findings indicate that GLE has a potentially beneficial effect on alleviating alcohol-induced liver injury and may be developed as a promising functional food ingredient. Phytochemical analysis revealed that ethanol extract of Gaoderma lucidum (GLE) is rich in ganoderic acids. GLE ameliorated lipid metabolism, antioxidant function and inflammatory response in mice with excessive alcohol intake. Liver metabolomics based on UPLC-QTOF/MS was performed to reveal the underlying hepatoprotective effect of GLE. GLE intervention alleviated alcoholic liver injury partly through regulating the “gut-liver-metabolite”axis. Hepatic gene transcriptions related to lipid metabolism and inflammation were remarkablyinfluenced by GLE intervention.
Collapse
|
5
|
Suanrueang P, Peltzer K, Suen MW, Lin HF, Er TK. Trends and Gender Differences in Mental Disorders in Hospitalized Patients in Thailand. INQUIRY: THE JOURNAL OF HEALTH CARE ORGANIZATION, PROVISION, AND FINANCING 2022; 59:469580221092827. [PMID: 35420043 PMCID: PMC9019317 DOI: 10.1177/00469580221092827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Previous studies have shown that gender differences play a substantial role in the influence of mental disorders. This study was designed to investigate gender differences in mental disorders by presenting odd ratio (OR) trends and cumulative effects over a period of 13 years in Thailand. This observational study used hospital data from the Ministry of Public Health on selected patients admitted to inpatient departments in public hospitals with mental disorders, according to ICD-10 cause groups from 2007 to 2019, counting from more than 1,90,000 cases in 2007 to more than 4,00,000 cases in 2019. Data were collected from the Thailand Ministry of Public Health website. The results indicate that compared to women, men were positively related to five mental disorders revealed by the OR and the ratio per 100,000 population (mean and SD): psychoactive alcohol use (OR = 7.31-9.07, 271.19 (59.26)), substance abuse (OR = 5.06-7.82, 59.25 (33.71)), schizophrenia (OR = 1.64-1.93, 108.32 (19.62)), mental retardation (OR = 1.15-1.58, 10.64 (1.88)), and other mental and behavioral disorders (OR = 1.10-1.55, 70.67 (22.75)). Three mental disorders in men were found to be negatively related: neurotic and related disorders (OR=.34-.46, 27.98 (3.26)), mood (affective) disorders (OR = .44-.56, 31.91 (9.59)), and dementia (OR = .78-10.82, 13.75 (2.73)). Gender can become a key biological element that contributes to the dissimilarity of mental illness. Preventive care for men and women should, therefore, be prioritized for health conditions separately. More specifically, screening and detection, and providing appropriate intervention.
Collapse
Affiliation(s)
- Passakorn Suanrueang
- Department of Healthcare Administration Specialty in Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Karl Peltzer
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Mein-Woei Suen
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Hsiao-Fang Lin
- Department and Graduate Institute of Early Childhood Development and Education, Chaoyang University of Technology, Taichung, Taiwan
| | - Tze-Kiong Er
- Department of Medical Laboratory Science and Biotechnology, Asia University, Taichung, Taiwan
| |
Collapse
|
6
|
Biopsychosocial inequality, active lifestyle and chronic health conditions: a cross-sectional National Health Survey 2013 in Brazil. Sci Rep 2021; 11:24010. [PMID: 34907263 PMCID: PMC8671513 DOI: 10.1038/s41598-021-03549-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 12/03/2021] [Indexed: 02/07/2023] Open
Abstract
This study estimated the biopsychosocial factors related to active physical behavior in the Brazilian population with and without chronic non-transmissible disease (NCD). Cross-sectional study of the National Health Survey (NHS) in Brazil, with 60,202 individuals in 2013. Participants were randomly selected by complex sampling. The outcome was physically active behavior measured by performing a minimum of 150 min of physical exercise per week. The independent variables were social and psychological characteristics, lifestyle and health. Cox regression was applied to estimate the prevalence ratio (PR). There are 29,666 (48.3%; 95% CI 47.0–50.0) participants reported having NCD. Not being a smoker or alcoholic, living in an urban area (PR = 1.44; CI95% 1.23–1.68/PR = 1.38; CI95% 1.08–1.75), having informal social support (PR = 1.26; CI95% 1.10–1.44/PR = 1.19; CI95% 1.05–1.34), A social class (PR = 0.43; CI95% 0.25–0.73/PR = 0.46; CI95% 0.26–0.80), high schooling (PR = 0.34; CI95% 0.23–0.51/PR = 0.33; CI95% 0.24–0.46) as well as paid work (PR = 0.87; CI95% 0.78–0.96/PR = 0.89; CI95% 0.79–0.99) are more associated with active lifestyle in both groups. However, only in the group without NCD, the male sex (PR = 1.42; CI95% 1.28–1.57), no having some disability (PR = 1.31; CI95% 1.03–1.66) and having private health insurance (PR = 1.26; CI95% 1.13–1.41) were more associated with active behavior, while in the group with NCD, being elderly (PR = 1.22; CI95% 1.05–1.42), not be white (PR = 0.85; CI95% 0.77–0.95) and not having restful sleep (PR = 1.23; CI95% 1.08–1.40) are associated with active lifestyle. People with and without NCD in Brazil have very close active behavior, however, some biopsychosocial factors such as: sex, age, lifestyle, socioeconomic level are unevenly associated with the active lifestyle in the groups. Thus, therapeutic or preventive proposals as well as public policies for health promotion must observe these distinctions when elaborating their actions.
Collapse
|
7
|
Nan X, Lu H, Wu J, Xue M, Qian Y, Wang W, Wang X. The interactive association between sodium intake, alcohol consumption and hypertension among elderly in northern China: a cross-sectional study. BMC Geriatr 2021; 21:135. [PMID: 33622268 PMCID: PMC7903677 DOI: 10.1186/s12877-021-02090-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 02/16/2021] [Indexed: 11/18/2022] Open
Abstract
Background Hypertension is a worldwide public health problem. We sought to examine the interactive associations among sodium intake, alcohol consumption and hypertension among older adult residents of Inner Mongolia in northern China. Methods This cross-sectional study used data from the National Survey for Nutrition and Adult Chronic Disease in Inner Mongolia. The prevalence of hypertension was age standardized by the direct method. Sodium intake and alcohol consumption were estimated using a weighing method and 24-h recalls on 3 consecutive days. Hypertension was either self-reported or field-measured. Participants were categorized into six subgroups according to combinations of sodium intake status and drinking level. Logistic regression was used to determine the interactive effect of sodium intake and drinking on hypertension. Results Of the 820 older adults who participated in this study, 523 (63.80%, age-standardized rate = 62.33%) had been diagnosed with hypertension. The mean sodium intake was 4.88 g. Sodium intake and drinking excessively were both independently related to higher risk of hypertension. A formal test for a multiplicative interaction between sodium intake and drinking revealed a significant interaction (p = 0.042), and the multivariable-adjusted odds ratio (95% CI) for the interaction was 1.1 (1.0–1.3). After adjusting for confounders, compared with moderate sodium intake and no drinking group, the risk of hypertension was highest among those with both excessive sodium intake and excessive alcohol consumption, with an odds ratio of 3.6 (95% CI: 1.7–7.9). Conclusions The study highlights the interactive effect of sodium intake and alcohol consumption on hypertension. Primary health care providers should pay special attention to older adults with hypertension—especially those with an unhealthy diet including both excessive sodium and excessive alcohol intake. These findings are applicable for older adults in Inner Mongolia and worldwide.
Collapse
Affiliation(s)
- Xi Nan
- Department of Health Statistics, School of Public Health, Inner Mongolia Medical University, Jinshan Development District, Hohhot, 010110, China
| | - Haiwen Lu
- Department of Medical Imaging, Affiliated Hospital of Inner Mongolia Medical University, Inner Mongolia Medical University, Hohhot, 010050, China
| | - Jing Wu
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 100050, China
| | - Mingming Xue
- School of Basic Medicine, Inner Mongolia Medical University, Hohhot, 010110, China
| | - Yonggang Qian
- Department of Chronic Disease Control and Prevention, Inner Mongolia Center for Disease Control and Prevention, Hohhot, 010031, China
| | - Wenrui Wang
- Inner Mongolia Center for Disease Control and Prevention, Hohhot, 010031, China
| | - Xuemei Wang
- Department of Health Statistics, School of Public Health, Inner Mongolia Medical University, Jinshan Development District, Hohhot, 010110, China.
| |
Collapse
|
8
|
Functional-Belief-Based Alcohol Use Questionnaire (FBAQ) as a Pre-Screening Tool for High-Risk Drinking Behaviors among Young Adults: A Northern Thai Cross-Sectional Survey Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041536. [PMID: 33562789 PMCID: PMC7915812 DOI: 10.3390/ijerph18041536] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 01/28/2021] [Accepted: 02/02/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND an alcohol-use disorders identification test (AUDIT) is a standard screening tool for high-risk drinking behavior. Standard drink calculation is difficult to comprehend and may lead to inaccurate estimates. This study intended to develop a practical pre-screening tool for the identification of high-risk drinkers among young adults. METHODS a cross-sectional survey was conducted in Northern Thailand from July 2016 to December 2016. Data was collected on relevant characteristics and health beliefs about drinking. The 12-month AUDIT was used as the reference standard. Logistic regression was used for the score derivation. The discriminative ability was measured with an area under the receiver operating characteristic curve (AuROC). RESULT a total of 1401 young adults were included. Of these, 791 people (56.5%) were current drinkers. Three functional-belief items were identified as independent predictors of high-risk drinking and were used to develop the functional-belief-based alcohol-use questionnaire (FBAQ). The FBAQ demonstrated an acceptable discriminative ability-AuROC 0.74 (95% confidence interval (CI) 0.70, 0.77). CONCLUSION The FBAQ contains only three simple belief questions and does not require unintelligible standard drink calculation. Implementing the FBAQ score and the AUDIT in a serial manner might be a more effective method in a mass-screening program for alcohol-use disorder in young adults.
Collapse
|
9
|
Charoensab N, Pinyopornpanish K, Thangsuk P, Jiraporncharoen W, Angkurawaranon C. Lowered blood pressure targets identify new, uncontrolled hypertensive cases: patient characteristics and implications for services in Thailand. BMC Health Serv Res 2020; 20:869. [PMID: 32928210 PMCID: PMC7490895 DOI: 10.1186/s12913-020-05719-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 09/07/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND According to the new hypertension treatment guidelines blood pressure (BP) readings need to be kept below or equal to 130/80 mmHg in patients aged less than 65 years old. This study shows the change in proportion of identified cases of uncontrolled blood pressure in light of these changes. METHODS The data was collected from 248 hypertensive patients who had visited an outpatient clinic at the Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Thailand. Patients were classified into three groups: The 3 groups were: 1) controlled BP group (BP is 130/80 mmHg or lower); 2) newly identified uncontrolled group (BP between 130/80 mmHg and 140/90 mmHg) and 3) existing uncontrolled group (BP higher than 140/90 mmHg). Health behaviors, past history related to hypertensive disease and current pharmacological treatments were compared. RESULTS Of the total 248 patients, 56% were female and the mean age was 58.8 (sd 5.99) years old. Following application of the new guidelines, the group designated as uncontrolled increased from 21.7 to 74.2%, an additional 52.4% due to new BP targets. Higher BMI was associated with uncontrolled HT (p = 0.043). While the average number of medication taken was similar across the three groups, it was poor medication adherence (p < 0.013) which was associated with the uncontrolled disease. CONCLUSIONS Lower BP targets will increase the number of identified hypertensive patients. While intensifying pharmacological treatment may be considered, our study suggests that two behavioral factors should not be overlooked. Weight reduction and enhancement of medication adherence remains an important mainstream treatment strategy.
Collapse
Affiliation(s)
- Naphassanan Charoensab
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Intawarorot Rd, Sriphum, Muang, Chiang Mai, 50200, Thailand
| | - Kanokporn Pinyopornpanish
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Intawarorot Rd, Sriphum, Muang, Chiang Mai, 50200, Thailand
| | | | - Wichuda Jiraporncharoen
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Intawarorot Rd, Sriphum, Muang, Chiang Mai, 50200, Thailand
| | - Chaisiri Angkurawaranon
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Intawarorot Rd, Sriphum, Muang, Chiang Mai, 50200, Thailand.
| |
Collapse
|